Highmark Insurance Coverage For Addiction Treatment Services
Safe Haven Recovery is dedicated to supporting individuals and families facing substance use disorders. We work with many Highmark plans and offer a range of addiction treatment services, including outpatient programs and experiential therapies, all centered on personalized care and lasting recovery.
When you are ready to start treatment, understanding how your Highmark plan works can make the process simpler and less stressful. Highmark plans commonly include behavioral health benefits for substance use disorders, counseling, and medications, which can lower the cost of care when services are medically necessary. Because benefits differ by product and service area, verifying your plan is the best first step.
Verify Your Benefits by Phone
About Highmark Insurance
Highmark is part of Highmark Health, a diversified health and wellness enterprise based in Pittsburgh. As an independent licensee of the Blue Cross Blue Shield Association, Highmark Inc. and its affiliated health plans focus on delivering high-quality, accessible, understandable, and affordable care. Highmark remains one of the nation’s largest Blue plans, serving approximately 7 million members across Pennsylvania, Delaware, West Virginia, and western and northeastern New York.
What Does Highmark Typically Cover for Addiction Treatment?
Most Highmark products cover a continuum of evidence-based services when they meet medical necessity criteria:
- Medical detoxification: Supervised withdrawal management for alcohol or drugs when clinical monitoring is needed. Higher levels of behavioral health care often require prior authorization.
- Residential or inpatient rehabilitation: Live-in care with structured therapy and support. These services often require authorization prior to admission.
- Partial hospitalization and intensive outpatient programs: Robust, multi-day therapy each week while you live at home. Coverage depends on your plan’s benefits and network rules.
- Outpatient therapy and medications: Follow-up counseling and, when indicated, medication for opioid use disorder are coordinated through your plan’s medical and pharmacy benefits.
Two federal protections help explain why these benefits exist. First, the Affordable Care Act requires non-grandfathered individual and small-group plans to cover Essential Health Benefits, which include mental health and substance use disorder services. Second, the Mental Health Parity and Addiction Equity Act (MHPAEA) requires plans that offer behavioral health benefits to apply financial requirements and treatment limits in a manner that is no more restrictive than the standards used for medical and surgical care.
Highmark Service Areas and Why Verification Matters
Highmark operates several local Blue plans. Service areas include western, central, and southeastern Pennsylvania, all of Delaware and West Virginia, as well as designated counties in western and northeastern New York. Because each plan has its own network and administrative rules, verifying your specific benefits before scheduling treatment prevents surprises.
How Safe Haven Recovery Helps You Use Highmark Benefits
Starting care should feel manageable. Here is how we help:
- Fast insurance verification. Share your member ID, date of birth, and contact details. We confirm eligibility, in-network status, and what your plan covers. Highmark directs providers and members to verify benefits in advance, which we handle for you.
- Prior authorization support. Many higher levels of behavioral health care require authorization. Highmark instructs providers to submit requests through its Availity-based portal, and we prepare the clinical documentation and submit on your behalf. Authorization helps confirm medical necessity for coverage, and we keep you informed of the determinations.
- Clear next steps. Once coverage and any necessary approvals are confirmed, we will coordinate your admission or outpatient start date, outline any visit limits, and explain any ongoing reviews that may apply during your care.
This place is awesome! Great techs, great therapists, great clients, great owners, and a great chef! It went beyond my expectations, and this was my first time in rehab. Safe Haven is highly recommended by me.
- Donna M.
What Treatment Looks Like at Safe Haven Recovery
We align your care plan with common Highmark coverage pathways, tailoring services to meet your specific needs.
- Medical Detox: If you need supervised withdrawal, our medical team manages symptoms and monitors your safety. We submit the required clinical information for authorization when needed.
- Residential Treatment: A structured, live-in setting helps you step away from triggers and practice recovery skills through daily therapy, skills groups, and wellness practices. Authorization is commonly required for this level of care.
- Outpatient Treatment: Weekly or biweekly sessions help you develop coping skills, practice relapse prevention, and sustain progress while you live at home. We coordinate scheduling, verify your Highmark benefits, and review any copays or coinsurance before your start date.
- Medication-Assisted Treatment (MAT): When appropriate, FDA-approved medications such as buprenorphine or naltrexone, combined with counseling, help reduce cravings, ease withdrawal, and support long-term recovery. We coordinate prescribing and monitoring, confirm pharmacy benefits and any prior authorization requirements with Highmark, and review copays, coinsurance, and deductibles in advance to ensure a seamless experience.
Understanding Out-of-Pocket Costs
Even with coverage, your plan may include a deductible, copay, or coinsurance. Under MHPAEA, financial requirements and treatment limits for behavioral health cannot be more restrictive than those for comparable medical or surgical services. We explain these costs in plain language and confirm your remaining deductible and expected copays before you begin.
Using Your Highmark Plan Outside Your Home Region
Traveling or living outside your home area does not have to interrupt care. Many Highmark plans include BlueCard, which offers access to provider networks of other independent Blue plans nationwide and abroad. Benefit designs vary, so we verify your specific plan’s BlueCard participation and in-network options before scheduling services.
Verify Your Insurance
Please complete the following information for the person seeking treatment. One of our dedicated team members will contact you immediately to go over your coverage, treatment options and information on admissions.
Contact Person
Get Started With Highmark Insurance for Addiction Treatment at Safe Haven Recovery
You do not have to navigate benefits alone. Our team will help verify your Highmark coverage, explain out-of-pocket costs, and request any necessary authorizations, so you can focus on your recovery. Contact us to review your benefits and explore your next steps.
Sources
- Highmark. (n.d.). Member guide. Retrieved from https://www.highmark.com/member/member-guide
- Centers for Medicare & Medicaid Services. (2024, September 10). Mental Health Parity and Addiction Equity Act (MHPAEA).https://www.cms.gov/marketplace/about/oversight/other-insurance-protections/mental-health-parity-and-addiction-equity-act-mhpaea
- Centers for Medicare & Medicaid Services. (2025, January 14). Information on essential health benefits (EHB) benchmark plans.https://www.cms.gov/marketplace/resources/data/essential-health-benefits
- Highmark. (2024, July 1). Behavioral health forms. Provider Resource Center. https://providers.highmark.com/resources-and-education/forms/behavioral-health-forms.html
- Highmark. (n.d.). Unit 2: Authorizations. Provider Resource Center, Highmark Provider Manual, Chapter 5: Care & Quality Management. Retrieved from https://providers.highmark.com/resources-and-education/highmark-provider-manual/chapter-5-care-and-quality-management/unit-2-authorizations.html
- Highmark. (2025). What is my service area? [PDF]. Provider Resource Center. https://providers.highmark.com/content/dam/highmark/en/providerresourcecenter/pdfs/education-resources/highmark-provider-manual/provider-manual-chapter-1/hpm-service-area-map.pdf
Client Reviews & Success Stories
We value the feedback from our many clients and we are proud of these success stories. Knowing we have made a positive impact on the lives of these individuals and families is most important to us.
John Chaney
1 year ago
After going to several Behavioral programs, Safe Haven was by far the best in-patient facility I’ve ever been to. They have a great clinical team and therapist that make a difference….
Posted on
Megan Chaney
10 months ago
Save Haven was by far the best in-patient facility I’ve ever been to. They have a great clinical team and therapist that make a difference. This was by far the best in-patient facility I’ve ever been to. They have a great clinical team and therapist that make a difference….
Posted on
Jazz j
10 months ago
Thank you, thank you! You have made the process seemless and we have been treated with such grace Thank you.
Posted on
Highmark Insurance Rehab Coverage FAQs
Does Highmark cover rehab at Safe Haven Recovery?
What levels of care does Highmark cover for addiction treatment and mental-health treatment?
Highmark plans generally include behavioral health benefits for substance use disorders and co-occurring mental-health conditions when medically necessary, including:
Medically-Supervised Detoxification (withdrawal management)
Inpatient/residential rehabilitation with 24/7 care
Partial Hospitalization Programs (PHP)
Intensive Outpatient Programs (IOP)
Outpatient therapy and counseling including medication-assisted treatment (MAT) when indicated
Coverage depends on your plan’s region, network status, and medical necessity.
Does Highmark cover dual-diagnosis (addiction + mental health) treatment at Safe Haven Recovery?
Yes. Highmark recognizes integrated dual-diagnosis care as part of essential health benefits under the ACA and the Mental Health Parity and Addiction Equity Act.
Safe Haven Recovery’s rehab program in Beverly Hills / Los Angeles aligns with these standards by treating both addiction and mental-health issues concurrently.
Will I need prior authorization?
Does Highmark limit the number of days or types of care for rehabilitation?
Yes — coverage may vary depending on the plan and service area. Some Highmark plans impose day-limits on residential care or require a step-down to outpatient programs (PHP/IOP). Safe Haven Recovery works with Highmark to coordinate a care plan that aligns with clinical needs and benefit structure.
What if I'm unsure which Highmark company administers my plan?
Will Highmark cover luxury or boutique rehab amenities at Safe Haven Recovery?
Highmark typically covers medically necessary addiction and mental health treatment services. Luxury amenities — such as private suites, spa-level extras, or extended stay solely for comfort — may not be fully covered unless they are deemed medically necessary and preapproved.
How quickly can I begin treatment using Highmark benefits at Safe Haven Recovery?
Once Highmark coverage is verified and any required prior authorizations are approved, placement at Safe Haven Recovery can often be arranged promptly, often within 24 hours of insurance authorization.
The admissions team works with you and Highmark to streamline logistics and start treatment with minimal delay.
What out-of-pocket costs can I expect with Highmark for dual-diagnosis rehab?
Your costs depend on your specific Highmark plan: HMO vs PPO, how much of your deductible is fulfilled, the coinsurance percentage, whether Safe Haven Recovery is in-network, and any plan-specific daily or stay limits.
Safe Haven Recovery will provide a clear cost estimate and outline what you’re responsible for up front.
Does Highmark cover aftercare, alumni support, or peer-support groups for addiction and mental health?
Many Highmark plans include outpatient therapy, relapse-prevention services, and behavioral-health follow-up under their benefits.
Safe Haven Recovery will help connect you with aftercare resources — including peer groups and alumni programs — to support long-term recovery.
How can I start the verification and admissions process with Safe Haven Recovery using my Highmark benefits?
Call (855) 893-3566 or complete our secure online form. Provide your Highmark plan details and member ID. Our admissions team will verify your coverage, review available treatment levels at our Beverly Hills/Los Angeles location, estimate any out-of-pocket costs, and coordinate next steps for admission.
We Accept Most Insurance
We accept most major insurance providers including the ones displayed here.
Submit your insurance to confirm coverage.
